GP health campus vision for London

A report by a surgeon could lead to major upheaval for GPs. Julie Griffiths and Prisca Middlemiss report

For a surgeon, Professor Ara Darzi wields considerable influence over how general practice could look in the future.

In his report, ‘Saws and Scalpels to Lasers and Robots: advances in surgery’, published last month, the national adviser on surgery set out the clinical need for change in the way surgical healthcare is delivered.

Professor Darzi argued in his DoH-commissioned report that the only way for patients to fully benefit from advances in surgical technology was to redesign services.

The changes that have taken place in the past two decades, such as an increased use of lasers and keyhole surgery, meant that procedures that once required long hospital stays could be done as day cases, the report said. 

‘The NHS is not yet providing surgery in a way that makes the most of the progress in surgery over the past 20 years,’ Professor Darzi said.

Local centres, including large GP practices, should carry out around 80 per cent of planned surgery,’ he said in the report.

Much of the minor surgery required could be performed under local anaesthetic.

The remaining 20 per cent of surgery would take place in specialised centres, handled by highly skilled surgeons.

Professor Darzi, chairman of surgery at London’s Imperial College, is accustomed to redesign. He has also been commissioned by NHS London to draft a plan for healthcare in the capital over the next decade.

His vision for London is a network of 24-hour ‘one-stop shop’ health campuses, each housing as many as 25 GPs.

Each campus will include an urgent care centre and premises for a cluster of GPs who would have access to diagnostics and outreach consultants to avoid referring patients to secondary care.

Each urgent care centre would provide services for a population of 100,000 people.

South London GP Dr Tom Coffey chaired the long-term conditions workstream, one of six feeding into the new strategy.

‘This is about the co-location of GPs with urgent care centres. It is not about GP surgeries being open 24 hours a day,’ said Dr Coffey.

Co-locating GP surgeries so that all services would be provided from a single site would require new premises, Dr Coffey explained.

His own practice in south London covers 20,000 patients and he would not want it to get any bigger.

However, he said: ‘It would be good for us to have a nice, new building with access to facilities like X-ray and pathology.’

Professor Darzi’s report is expected to be published in the next two months.

But not everyone is convinced. GP negotiator and secretary of Londonwide LMCs Dr Stewart Drage said that the focus should be on good quality patient care, not how GPs are grouped together. He called for debate about redesigning services to ensure that the positive elements of general practice were not lost.

Paul Haigh, director of East London Integrated Care, a GP commissioning group in City and Hackney PCT, said that any redesign would need to be backed by public education so that patients were not under the impression that they could get a routine GP appointment at any hour of the day.

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